Marvellous Okere

WOMEN AND CERVICAL CANCER Cervical cancer is one of the undermined terminal diseases which has ravaged the lives of women, but very unfortunate that most women have less or no knowledge of it. Before we proceed to its cause and cure, let's first understand what the word 'Cervix' means. The Word cervical is created from the Word Cervix. At the bottom of your uterus lies a narrow passage known as the cervix which acts as a connector between it and your vagina, 1 fulfilling the important function of allowing fluids to move between your uterus and vagina. The cervix is sometimes called the “neck of the uterus”. Another word for the Uterus is Womb. CERVICAL CANCER: Cervical cancer is cancer that starts in the cells of the cervix. Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as ‘dysplasia’ [the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer], in which abnormal cells begin to appear in the cervical tissue. Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and to surrounding areas. 2 All women are at risk of cervical cancer, it occurs often in women over the age of 30 and above. Most Women may not know they have cervical cancer until they are formally diagnosed with the disease. A healthcare provider will be able to confirm cervical cancer through a series of tests and biopsies. The first signs of cervical cancer are usually mild and can only be detected by a healthcare provider. Advanced stages of cervical cancer are more likely to cause signs and symptoms. 3 Cervical cancer has four stages. It takes the grace of God for any woman at the fourth stage of cancer to pull through. FOUR STAGES OF CERVICAL CANCER: stages of cervical cancer are identified with a complete clinical exam that is performed after a diagnosis is confirmed. Cancer can be staged through a combination of imaging, physical exams, biopsies, tissue diagnoses and sometimes surgery. The results are used to determine the size of any tumors, whether the cancer has invaded tissues in and around the cervix and whether it has spread to other areas of the body. Doctors use the International 4 Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer. There are 4 stages; 1. STAGE 0: Also called ‘Carcinoma in situ’. precancerous cells are present. This stage is sometimes considered ’pre-cancer’ because the abnormal cells are only at the surface layer of the cervix and have not moved into deeper layers of cells. When cancerous cells are detected at this early stage, they can generally be successfully destroyed with proper treatment. ● STAGE 1: Cancer cells have grown from the surface into deeper tissues of the cervix. This means that the cancer is within the neck of the womb (cervix). It hasn’t spread to nearby tissues or other organs. It is often divided into: 1. Stage 1A 5 2. Stage 1B The main treatment is surgery. ● STAGE 2: The cancer has moved beyond the cervix and uterus. This means the cancer has spread outside the cervix, into the surrounding tissues. But it has not grown into the muscles or ligaments that line the pelvis (the area between the hip bones), or to the lower part of the vagina. It can be divided into: 1. Stage 2A 2. Stage 2B The main treatments are a combination of chemotherapy and radiotherapy (chemoradiotherapy), sometimes it may require surgery. ● STAGE 3: 6 Cancer cells are present in the lower part of the vagina or the walls of the pelvis and may block the uterus. This means the cancer has spread from the cervix into the structures around it or into the lymph nodes in the pelvis or abdomen. It usually has a combination of chemotherapy and radiotherapy (chemoradiotherapy) for stage 3 cervical cancer. It can be divided into: 1. Stage 3A 2. Stage 3B 3. Stage 3C Which is then further divided into stages 3C1 and 3C2 if scans show cancer has spread to the lymph nodes. STAGE 3A: Stage 3A is when the cancer has spread to the lower third of the vagina but not the pelvic wall. 7 STAGE 3B: Stage 3B means the tumor has grown through to the pelvic wall or is blocking 1 or both of the tubes that drain the kidneys (the ureters). STAGE 3C: Stage 3C means the cancer can be any size in the pelvis but has not spread to distant sites in the body. If scans show cancer has spread to lymph nodes, 3C is then divided into: 1. 3C1 2. 3C2 Stage 3C1 means cancer is in the nearby pelvic lymph nodes. 8 Stage 3C2 means cancer is in the para-aortic lymph nodes (in the abdomen). ● STAGE 4: It affects the bladder or rectum and it is growing out of the pelvis. This means the 9 cancer has spread to the bladder or back passage (rectum) or further away. The cancer has spread to parts of the body outside the cervix and womb. It can be divided into stages; 1. STAGE 4A 2. STAGE 4B The main treatments are surgery, radiotherapy, chemotherapy or a combination of these treatments. Or you might have treatment to control symptoms. Stage 4A is when the cancer has spread to nearby organs such as the bladder or back passage (rectum). Stage 4B is when the cancer has spread to organs further away, such as the lungs. Your 10 doctor might call this secondary or metastatic cancer. SIGNS AND SYMPTOMS OF CERVICAL CANCER: In the early stage of C.C ( cervical cancer) some people may present with no symptoms while some will present. ● Bleeding between periods ● Bleeding after sexual intercourse ● Discomfort during sexual intercourse ● Vaginal discharge with strong odor ● Vaginal discharge with blood ● Serious Pelvic pain. As a woman, it is important and necessary that you know your body. When you observe any 11 unusual changes, reach a doctor for a possible diagnosis and immediate treat. The main cause of this cancer is Human papillomavirus [HPV]. HPV is a common virus that is passed from one person to another during sex. OTHER CAUSES INCLUDES; ● Having numerous sex partners. ● Being Sexually active from an early age. ● Smoking ● Weakened immune system ● Birth control pills. A long term use of it poses risk. ● Sexually transmitted disease. [STD]. 12 THE CERVICAL CANCER VACCINE: The HPV vaccine is approved for children and adults ages 9 to 45, It protects against the development of cervical cancer. The vaccine works by triggering your body's immune system to attack certain human papillomavirus [HPV] types, which have been linked to many cases of cervical cancer. It is best to get the vaccine before the start of sexual activity. The vaccine is given in series. The number of shots you need varies, depending on the age you are at your first dose. It is advisable to check with a healthcare provider to see if you are eligible for the vaccine diagnosis, which is the best way to find and discover if one has Cervical cancer. 13 BIMANUAL PELVIC EXAMINATION AND STERILE SPECULUM EXAMINATION: A speculum examination and a bimanual examination are often done together, these examinations are used to check a woman's reproductive organs. In this gynecological examination, the doctor will check for any unusual changes in the patient's cervix, uterus, vagina, ovaries, and other nearby organs. OTHER TESTS TO BE DONE: ● Pap smear test; usually done every three years. ● Human papillomavirus typing test. ● Colposcopy ● Biopsy. N.B; pap smear and HPV test are similar. TREATMENT OF CERVICAL CANCER: The treatment depends on the stage. 14 Once investigations show there is Cervical Cancer, the next line of action is to manage the situation before it gets worse. Recommended treatment for cervical cancer is based on many factors including the stage of the disease, the patient's age and general health. If the patient wants children in the future. The treatments for cervical cancer are radiation, chemotherapy, surgery, targeted therapy and immunotherapy. RADIATION THERAPY: It uses energy beams to kill cancer cells on your cervix. There Are Two Types Of Radiation Therapy: ● External beam radiation therapy (EBRT): Aims high-powered radiation at cancer from a machine outside your body. 15 ● Brachytherapy: Puts the radiation in or just near cancer. CHEMOTHERAPY: Chemotherapy (chemo) uses drugs that are injected through the veins or taken by mouth to kill cancer cells. It enters the blood and is effective for killing cells anywhere in the body. There are several drugs used for chemo and they can be combined. Chemo is often given in cycles. The length of the cycle and the schedule or frequency of chemotherapy varies depending on the drug used and where cancer is located. SURGERY: Different kinds of surgery are used to treat cervical cancer. Some of the most common kinds of surgery for cervical cancer include: ● Laser surgery: This surgery uses a laser beam to burn off cancer cells. 16 ● Cryosurgery: This surgery freezes cancer cells. ● Cone biopsy: A surgery in which a cone-shaped piece of tissue is removed from the cervix. ● Simple hysterectomy: This surgery involves the removal of the uterus but not the tissue next to the uterus. The vagina and pelvic lymph nodes are not removed. ● Radical hysterectomy with pelvic lymph node dissection: With this surgery, the uterus, surrounding tissue called the parametrium, the cervix, a small portion of the upper part of the vagina and lymph nodes from the pelvis are removed. ● Trachelectomy: This procedure removes the cervix and the upper part of the vagina but not the uterus. ● Pelvic exenteration: This is the same as a radical hysterectomy but includes the 17 bladder, vagina, rectum and part of the colon, depending on where cancer has spread. The cervical cancer treatment team includes a gynecologic oncologist [a doctor who specializes in cancers of female reproductive organs]. HOW TO PREVENT CERVICAL CANCER: ● HPV vaccine ● Safe sex. ● Cervical screening. ● Having fewer sexual partners. ● Quit smoking. ● Apt treatment of STDs CONCLUSION: One sexual partner is enough, go for a pap smear test to know your status. 18 Visit a family planning center and choose one method that suits your body and stop taking contraceptives ignorantly. 19